Claudia Janz1*, Jürgen Heinrich2 and Ralf Buhl1
1Department of Neurosurgery, Municipal Hospital Solingen, Germany
2Former Head of the Central Laboratory, Municipal Hospital Solingen, Germany
Objectives: Due to an aging patient population, neurosurgeons are increasingly confronted with patients taking Acetylsalicylic Acid (ASA) as an antiplatelet agent. Since a normal platelet function is frequently deemed necessary for neurosurgical interventions, the usefulness of the PFA-100® test to evaluate the platelet function is assessed. Methods: We retrospectively evaluated data on all neurosurgical patients subjected to a PFA-100® Platelet Aggregometry (PA) test between 6/12 and 2/17 and noted the reasons the test was done, the time required for platelet function to normalize, and how well the test results correlated with intraand postoperative findings. Results: PA had been performed on 171 patients, the reason being ASA treatment in 154 and coagulation analysis in 17. The PAs of the operated patients admitted for emergency treatment normalized between 0-19 days after ASA withdrawal (53%: 0-3, 34%: 4-6, 6%: 7, 7%: >7 days). With a mean of 3.7 days, the average time was found to be considerably shorter than the expected 7 days. 144 ASA patients underwent surgery. None of the 124 patients with normal and 3/20 with abnormal PAs had to be re-operated on. Discussion: Since normal PA test results correlated well with uncomplicated surgery, the study suggests that the test might be a reliable tool to time an operation in neurosurgical ASA patients. As 87% of the patients regained a normal platelet function in less than 7 days, the interval between last ASA administration and a neurosurgical procedure can often be reduced
Janz C, Heinrich J, Buhl R. Is PFA- 100® ADP/Epinephrine Platelet Aggregometry a Helpful Tool in Neurosurgical Patients on Acetyl Salicylic Acid Medication?. Clin Surg. 2020; 5: 2872..